Symphysis Pubis Dysfunction: Symptoms, Causes, Treatment

What are the symptoms of symphysis pubis dysfunction?

Symphysis pubis dysfunction (SPD) is a condition affecting the pelvis, particularly the joint where the two halves of the pelvis meet at the front, called the symphysis pubis. Symptoms can vary in intensity but typically include:

• Pelvic Pain: Pain in the front of the pelvis, often located around the symphysis pubis. This pain may worsen with movement, such as walking or climbing stairs.
• Hip Pain: Pain in the hips, which may be referred from the pelvic area. It can affect one or both sides.
• Lower Back Pain: Discomfort or pain in the lower back, which can be associated with the altered mechanics of the pelvis.
• Difficulty with Movement: Problems with walking, turning, or shifting weight from one leg to the other. Activities that require shifting or bearing weight may be challenging.
• Clicking or Grinding Sensation: Some individuals may experience a clicking or grinding sensation in the pelvis, especially with movement.
• Pain with Certain Positions: Pain may be more noticeable in certain positions, such as lying on one side, getting in and out of bed, or during specific activities.
• Discomfort with Physical Activity: Pain or discomfort during or after physical activity, such as exercise or prolonged standing.

SPD is often associated with pregnancy due to hormonal changes and increased stress on the pelvic joints. However, it can also occur outside of pregnancy or as a result of trauma or other underlying conditions. Management typically involves physical therapy, pelvic support, and pain management strategies.

What are the causes of symphysis pubis dysfunction?

Symphysis pubis dysfunction (SPD) arises from a range of factors that affect the stability and function of the symphysis pubis, the joint at the front of the pelvis. The main causes and contributing factors include:

• Pregnancy and Childbirth: Hormonal changes during pregnancy, particularly increased levels of relaxin, cause the pelvic ligaments to become more flexible to accommodate childbirth. This increased flexibility can lead to instability and discomfort in the symphysis pubis. The mechanical stress and strain during labor and delivery can also contribute to SPD.
• Trauma or Injury: Direct trauma to the pelvic area, such as from a fall, accident, or sports injury, can cause or exacerbate SPD by damaging the ligaments or disrupting the joint alignment.
• Overuse or Repetitive Strain: Activities that place repetitive stress on the pelvis, such as certain sports or physical activities, can lead to or worsen SPD. This includes activities that involve heavy lifting, running, or excessive movement.
• Previous Pelvic Surgery: Surgical procedures involving the pelvis, such as a cesarean section or pelvic surgery, can contribute to SPD by affecting the alignment or function of the symphysis pubis.
• Muscle Imbalances: Weakness or imbalance in the muscles surrounding the pelvis, including the abdominal, hip, and pelvic floor muscles, can impact the stability and support of the symphysis pubis.
• Underlying Conditions: Certain medical conditions, such as inflammatory or degenerative joint diseases, may affect the pelvic joints and contribute to the development of SPD.
• Biomechanical Factors: Abnormal gait or posture can place additional strain on the pelvic joints, potentially leading to or exacerbating SPD.

Addressing SPD typically involves managing the symptoms through physical therapy, pelvic support, and other interventions to improve joint stability and reduce discomfort.

What is the treatment for symphysis pubis dysfunction?

Treatment for symphysis pubis dysfunction (SPD) aims to alleviate pain, stabilize the pelvic joint, and improve overall function. The approach typically includes a combination of the following:

• Physical Therapy: A physical therapist can design exercises to strengthen the muscles around the pelvis, improve stability, and enhance overall movement. Therapy may include specific exercises for the pelvic floor, hip muscles, and core.
• Pelvic Support: Using a pelvic belt or support garment can help stabilize the pelvis and reduce pain by providing external support to the symphysis pubis.
• Pain Management: Pain relief may be achieved through over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). In some cases, a healthcare provider may recommend other pain management techniques.
• Activity Modification: Avoiding or modifying activities that exacerbate pain, such as heavy lifting or high-impact exercises, can help prevent worsening symptoms.
• Postural and Gait Training: Learning proper body mechanics and gait techniques can reduce strain on the pelvic joint and improve function.
• Heat and Cold Therapy: Applying heat or cold to the affected area may help alleviate pain and inflammation.
• Manual Therapy: Techniques such as massage or joint mobilization performed by a trained therapist may provide relief and improve pelvic alignment.
• Education and Self-Care: Educating individuals about SPD and teaching strategies for managing symptoms, such as proper body mechanics and ergonomic adjustments, can be beneficial.
• Supportive Measures: In some cases, referral to a specialist such as an orthopedic or rheumatologic expert might be necessary for additional evaluation and treatment.

Treatment plans are tailored to the individual based on the severity of the symptoms, the underlying causes, and the specific needs of the patient.